The Diagnostic Accuracy of PET(CT) in Patients With Neuroblastoma: A Meta-Analysis and Systematic Review

Abstract

Objective The objective of this study was to evaluate the overall diagnostic value of PET(CT) in patients with neuroblastoma (NB) based on qualified studies. Methods PubMed, Cochrane, and Embase database were searched by the index words to identify the qualified studies, and relevant literature sources were also searched. The latest research was performed in April 2019. Heterogeneity of the included studies was tested, which was used to select proper effect model to calculate pooled weighted sensitivity, specificity, and diagnostic odds ratio (DOR). Summary receiver operating characteristic (SROC) analyses were also performed. Results Eleven studies with 580 patients were involved in the meta-analysis to explore the diagnostic accuracy of PET(CT) for NB. PET(CT) has high diagnostic accuracy of NB: the global sensitivity was 91% (95% confidence interval [CI], 86%–94%), the global specificity was 78% (95% CI, 66%–86%), the global positive likelihood ratio was 4.07 (95% CI, 2.54–6.50), the global negative likelihood ratio was 0.12 (95% CI, 0.08–0.18), the global DOR was 27.43 (95% CI, 14.45–52.07), and the area under the SROC was high (area under the curve, 0.93; 95% CI, 0.90–0.95). Besides this, PET(CT) has high diagnostic accuracy of primary NB: the global sensitivity was 86% (95% CI, 73%–93%), the global specificity was 82% (95% CI, 57%–94%), the global positive likelihood ratio was 4.90 (95% CI, 1.63–14.72), the global negative likelihood ratio was 0.17 (95% CI, 0.07–0.40), the global DOR was 25.427 (95% CI, 3.988–162.098), and the area under the SROC was high (area under the curve, 0.91; 95% CI, 0.88–0.93). However, there has no significant accuracy of PET(CT) in NB with bone marrow. Conclusions This study provides a systematic review and meta-analysis of diagnostic accuracy studies of PET(CT) for NB. The results indicated that PET(CT) is a highly accurate diagnostic tool for NB.

Diagnostic Performance of 18F-FDG PET(CT) in Bone-Bone Marrow Involvement in Pediatric Neuroblastoma: A Systemic Review and Meta-Analysis

“…Our results were significantly different from the findings of Li and colleagues [9]. eir global sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and DOR were 17% (95% CI, 9%-30%), 78% (95% CI, 61%-89%), 0.80 (95% CI, 0.29-2.20), 1.05 (95% CI, 0.82-1.35), and 0.966 (95% CI, 0.254-3.671), respectively; the AUC was 0.32 (95% CI, 0.28-0.36).…”

“…Previous meta-analysis suggested that 18 F-FDG PET had a higher sensitivity but lower specificity than MIBG scintigraphy in NB lesion detection [8]. Another recent meta-analysis reported a 17% pooled sensitivity of positron emission tomography (computed tomography) (PET(CT)) for the detection of bone marrow in pediatric NB in their subgroup analysis, which was significantly lower than several studies [9][10][11][12][13][14][15][16]. Superiorities of PET are high 18 F-FDG avidity of the bone marrow and imaging of the entire marrow [17].…”

Long-term follow-up of children with neuroblastoma receiving radiotherapy to metastatic lesions within the German Neuroblastoma Trials NB97 and NB 2004

“…First, while in 17 of 18 patients of our study cohort the target volume was defined by the extension of the MIBG-active lesion at the time of RT, previous studies defined the target volume as the volume visible on cross-sectional studies either at initial staging or after induction chemotherapy. Due to these diverging approaches resulting in different target volumes, the comparison of data remains challenging [18][19][20]. There were no general recommendations for the irradiation of metastases within NB 97 and NB 2004 and the indication for RT to metastatic lesions was based on individual decisions, forming a risk for selection bias [21].…”

Rare tumors of the abdomen in children

“…Neuroblastoma may occur in any part of the sympathetic nervous system. [ 3 ] However, Neuroblastoma most often occurs in the posterior abdominal cavity, especially in the adrenal glands. The statistics from the Taiwan Children's Cancer Foundation show about 30–40 new cases in Taiwan every year.…”